Feeding FAQ: 3-4 months – Other

Should I be concerned about my 3 month daughter’s infrequent pooing?

My 3-month-old daughter is only having a bowel movement every 3-4 days, which is a fairly dark yellow/green/brown colour, and the consistency of yoghurt (although it can be more solid). This bowel movement is huge, and completely fills the whole nappy area. She never seems distressed when passing it, and is never fussy or irritable at other times. She is the quintessential CLB, and has slept through from her 10.30pm feed to her 7am feed since she was 9 weeks old. I fed her on only breast milk until she was about 6 weeks, then introduced a bottle of formula at 10.30, which she accepted readily, since then I have been following the weaning plan to get her onto formula exclusively. Currently only her 7am and part of her 6.15pm feeds are breast milk, both of which I express. She always feeds happily, seemingly not bothered by the transition to the bottle. I do give her one drink of cooled boiled water between her 2.30 and 6.15 feeds. The nurse at the paediatrician’s office suggested giving her 1oz of prune juice diluted in 1oz of water, which I haven’t tried yet. She also suggested tummy massage and inserting a thermometer into her rectum to stimulate bowel movement. (We are currently living in the USA). I’m sure the problem has something to do with the transition to formula (the one I use is fortified with iron, and made specifically for newborns to 6-month-olds), but as she seems happy with it I thought it was going well, but I am worried about the infrequent bowel movements.

As the consistency of your daughters bowel movement is fairly soft and she appears in no distress either before or when passing it, it would be better to accept that this is her natural rhythm. Some formula-fed babies do go more than one day without a bowel movement and it is not uncommon with breast-fed babies. As you are still in the process of changing her over completely to formula this may be the reason for the infrequency.
Massaging her tummy after her bath may stimulate her colon a little, which could result in more frequent but smaller stools, but if her rhythm is every 3-4 days then it is best to accept that and remember which day it is likely to happen.
Once she is fully on formula and you notice she does appear to be having more problems passing her stools, or is seen to be straining in between them, then giving her prune juice in water would be a good way to help her. Formula-fed babies can become constipated, but this would mean small hard pellets being passed. You would be aware of your babies discomfort and possible pain on passing them. If this should happen it would be best to ask your paediatrician for advice on how to deal with it.

Feeding FAQ: 3-4 months – Other

At 3 months old my daughter is still having problems bringing up her wind

My daughter has always had great difficulty bringing her wind up. I have tried Infacol, gripe water and cooled boiled water. All these methods have no impact whatsoever, however when she reached about 10 weeks she was able to bring her wind up alone. The past week however has been terrible; half way through her feed she screams out in agony and then will very rarely take the bottle again. I thought when babies reach 3 months they find it easier to burp. I’m at the end of my tether, I have spoken to the midwife and she has said try all the remedies which I already have done.
My daughter feeds at 8am 5ozs, 11am 3-6ozs, 2pm 3-6ozs, 5pm 3-6ozs, 8pm 3-6ozs. She uses a Dr Brown bottle with a level 2 teat. She weighs 11lbs 11ozs.
She naps at 9.30-11.10am, 11.45-1.30pm and settles at 8pm.

As your daughter has had issues with bringing up her wind when she was younger there are a couple of things you could try to try to help her now. Check the flow of the teats she is using is neither too fast or too slow for her. It could well be the former and she is drinking her milk too quickly. Teats are marked for age groups but not all babies may be happy with the one they are “supposed” to be on. Buy one pack of a smaller size and see if your daughter is happier when being fed.
Another idea to try is to give her a real break mid feed. Allow her to have 2-3 ozs and then wind her. Stop the feed before she becomes distressed and crying. Let her sit reclined, but in a straight posture in her chair. Any doubling over around her stomach may cause her pain and distress. A baby of this age may often benefit from a 20 min break mid feed to help them begin to digest the first part of their milk and be more content to take some more.
When winding your daughter, still take care to hold her as upright as possible. As babies get older they are usually easier to wind. The muscles are more developed and less floppy than a newborn but at 3 months many babies still do not have complete development of their entire trunk and still need to be helped in an upright position.
Try winding her held upright against you. Her head at shoulder height and on arm draped over your shoulder. This will keep the passage of the oesophagus as straight as possible. Rub her, rather than patting and concentrate on the left hand side of her back. Gently circle a few times and rub in an upward motion to help her burp without causing her too much distress. If nothing happens in 3-5mins and she is not crying, carefully sit her in her chair, keeping her as straight as possible. Angle the chair (if you are able to) so she is about 30-45 degrees rather than flatter on her back. Moving her into the chair may help her to wind. If she does need to burp she will begin to cry and you can repeat the position mentioned above and then let her rest before offering her the rest of her feed.

If, after trying all of the advice mentioned above, you find no improvement in your daughters discomfort, it would be definitely worthwhile visiting your doctor to discuss any possible gastric problems.

Feeding FAQ: 3-4 months – Other

3 month Twins feeding

I have 3-month-old twins, they seem to be doing very well on your schedule but I do find they get very sleepy before 9.00am and I find it difficult to keep them awake. They do not sleep through the night yet waking up between 3.00am and 5.00am and feed 10-15 minutes. Otherwise they do well through out the day except they have cat naps throughout the afternoon but I never have a problem putting them down at 7.00pm.
How do I know if they are getting enough milk as I am solely breastfeeding them? I do give them a bottle of 5-6oz at 10.30pm. But I cannot imagine I make 5-6oz per breast at each feed? So far they seem content but they both are starting to make sucking sounds and a lot of watery mouths?
Do you have any tips on twins as your book only mentions the one routine?
At present they feed at 7.30am 40 mins, 10.30am 40 mins, 12pm 5 mins, 2.30pm 40 mins, 4.15pm baby tea, a few sips, 6.15pm 40 mins, 10.30pm 5oz expressed bottle, 3-6am 10mins breast. The girls weigh 10 lbs and 12 lbs.
They nap at 9-9.45am, 12-2.15pm, 4-4.15pm 5.15-5.30pm.

You have done so well to have fully breast-fed both your girls and for them to be so settled into the routines. If they were not receiving enough milk for their needs they would be waking earlier and earlier for a feed, unable to settle to sleep at naptimes and would generally be less happy than they appear to be now. The fact that they are making sounds and have watery mouths may be the early signs of teething. They are beginning to use their mouth to explore their world as it is very sensitive to touch. This is why babies suck on anything which goes near to their mouth.
The amount of sleep a baby needs is a very individual thing. A baby of this age can stay awake for up to two hours, but many do need to settle for a nap before this. Using the routines as a guide whilst taking the girls own needs into account will help you structure their day. If they need to settle for their morning nap slightly earlier let them. To begin to stretch them nearer to 9am put them down 5 mins later every few days providing they continue to settle and sleep well for 45 mins. Go at the pace they are able to cope with, so always change things very slowly. As long as they continue to settle well at 7pm let them have their two cat naps in the afternoon. Begin to change things if things become difficult at 7pm.
If you look through the book at routines for singletons you will see that your daughters are following them in the same way as just one baby would. The only change you may need to make is to allow for extra time for feeding. You may have to begin a feed 15 mins earlier than the routine time to fit in feeding two. Adjusting and tweaking the routines for two can easily be done. If you are tandem feeding then the timings for singletons will not need that much adjusting.
If you notice that the girls are becoming less interested in the 7am feed then begin very slowly to cut back on the amount they are fed in the night. Look at notes on p 148 of The Contented Little Baby Book which explains how to gradually drop this feed. There is also a full description of the “core night” method which helps you eliminate this feed on p 42 of The Complete Sleep Guide. As they are completely breastfed they may need a feed around 5/6am followed by a top up at 7/7.30am which will get them through to their next feed.

Feeding FAQ: 3-4 months – Formula Feeding

Since being on antibiotics my 3 month daughter’s milk intake has dropped and she is reluctant to feed

My 3 month old daughter was diagnosed with a urinary tract infection 2.5 weeks ago and had to take antibiotics (Augmentin) for 1 week. During that week, her appetite reduced dramatically. She used to take 5.5oz each meal and only took 2-3oz while she was on antibiotics. She has since recovered and it’s been 1.5 weeks since her last dose of antibiotics but not only has her appetite not returned to normal, it has reduced even further. Now, she would only take 2oz and cries and cries. I have tried splitting her feeds but it’s not working. The baby clinic that I visit suggest I use a syringe to feed her the milk but my daughter would still cry and I really am not sure whether this is such a good method. Her daily intake of milk is reducing on a daily basis, from 27oz before she was ill to 20oz now. She seems to be taking less and less and not interested in milk at all especially the 7am feed. Her weight gain has been slower than before but apart from feeding problems, she seems happy. Also, in your books, you suggest the milk intake should be 2.5oz per pound. She weighs 5.3kg now, which means her daily intake should be close to 30oz but her daily intake is well below what you suggested.
At present she feeds at 7.30am 2-2.5ozs, takes a further 1oz by syringe, 10.50am 5.5ozs, 2pm 3-4ozs, 5pm 2ozs, 6.15pm 0.5-1oz but normally have to use a syringe, 10.30pm 4-5ozs. She weighs 12lbs.
She naps at 9-9.45am, 12-2pm, 4-4.20pm and is settled at 7pm.

As your daughter has recently been on antibiotics it would be sensible to take her back to your doctor and ask him to check her for any possible problems, such as oral thrush, which may be causing her reluctance to feed. This can occur as a result of antibiotic treatment. Your doctor will also be able to check that the original infection is fully cleared. Whilst it is usual for a baby to have a diminished appetite whilst ill, and it can take up to two weeks before they fully recover, her total reluctance to take much milk at all needs to be investigated.

Once she has been checked medically, and depending on the result, you may have to use some distraction techniques to get her to feed better. Walking around whilst being fed can often work well, especially if you are able to engage her attention by talking to her as well. You could also try feeding her in a quiet room, with some calming music playing. This will help you relax as well. Having a sick baby or one that appears disinterested in feeding is stressful and you are bound to tense up when it is time to feed her. She will quickly pick up on your tensions so if both of you are calm and quiet she may settle to feed a little better.

Continue to try to use split feeds to increase her intake to nearer 30ozs in 24 hours. This amount is an average to work towards but not all babies of this weight will want, or need, quite as much as that. Set yourself the target of 25ozs first and work towards that. Keep using the split feeds or top ups. As she seems reluctant to feed at 7.30am offer her a small feed at 9am, before going down for her nap, and again at mid-day. Even if she only takes 1oz each time it will all help her overall total.

Feeding FAQ: 3-4 months – Formula Feeding

I want to use the routine but my 16 week baby cries during feeding and takes too little

Please help me with a problem that your books don’t seem to address and it seems nobody can solve, including health visitors. I have a lovely baby boy who is 16 weeks and only drinks 17-20oz of milk per day. He was born at 38wks – 6lb 7oz and is an Indian baby. He was breastfed for the first 8 weeks but developed colic and mouth thrush at around 4 weeks so, being inexperienced, I put him on the bottle. He was only feeding for 5-6mins every 2-3hrs on the breast and I was worried he wasn’t drinking enough.
Colic would make him moan and bring his knees up to his chest every morning around 6am. He sleeps now around 6 hours every night from 1-2am to 7am and only drinks 1-2oz at this time. He then sleeps for another 2-3hrs. I feed him every 4 hours and each feed lasts between 11/2-2hrs e.g. start at 12pm, he will finish 3-4oz by 1.30pm and I will feed again around 4-5pm. I should also mention whilst drinking I can hear loud rumbling noises in his stomach and he will kick and shout and stop feeding. He also pulls his hair whilst feeding and, although I make sure the teat is full of milk, he wants to feed on the arm of the sofa or a pillow. He drinks Aptamil for hungrier babies from 3months, after starting on Aptamil First. I use Avent bottles and teats (no.2) and have tried the faster flow Avent teat but it made him cry and choke. He doesn’t cry when he’s hungry like most babies but may moan a little. I feel like I am force feeding him most of the time. Should I change the brand of milk? I also do give him gripe water after most feeds. I forgot to mention that my son sleeps on his stomach as I was advised this would help his colic.

He weighs 13lb 9oz and seems to be very intelligent, alert and active. He naps every couple of hours for approx 30-40mins. In the last few days for a couple of hours but no difference to feeding amounts.
I want to get him into the contented baby routine but at 16 weeks where should I start if he only drinks 17-20oz per day? I eagerly await and gratefully appreciate any advice you may have regarding this matter.


I feel that your son should be seen by a gastric specialist as soon as possible. You must ask your doctor for a referral to try to find why your son has such a problem with feeding and taking so long with each feed. Aptamil Extra is a casein-dominant milk which claims to take longer to digest and is more filling. I personally feel it can be harder to digest, especially with a baby who appears to have digestive troubles. There are milks on the market such as Cow and Gate Omneo which can help an unsettled baby. This must be fed with a Variflo or medium-sized teat. Speak to your Health Visitor or doctor before changing his milk.

You may find that using a softer teat could help your son. I have had success with using a “Variflo” made by Tommee Tippee. This will fit onto your existing Avent bottle. There is also a Dr Brown bottle on the market which can prevent excessive amounts of wind being swallowed whilst feeding. Again the teat is softer and the flow is controlled by the baby’s tongue. Both might be worth trying to see if your son is able to take a little more milk at each feed.

You can also buy a product called “Colief” which is added to each feed to make it easier to digest. You will find it in most chemist shops which stock baby goods.

With regards to putting your son on to a routine: when he wakes for the 7am feed, try to get him to stay awake for a while. If you can let him have a free kick on the floor, with some brightly-coloured toys to look at he may not be so sleepy at this time. If he will stay up for 1.5 hrs that would be the start of a routine. Let him have a sleep until 10am and then stir him again for another feed. What you are aiming for is to have two short naps in the morning and mid-afternoon, plus a longer one over midday. At the moment it would seem your son has this longer nap in the morning and then shorter ones in the day. It may take a while to begin to change this, but I hope once his feeding is better he will be able to enjoy some times awake after a feed and settle to a longer sleep at lunchtime.

Begin to build a bathtime and bedtime routine into your day. Start about 6pm and give him a bath before offering him a bottle at 6.30pm. If he last fed between 4-5pm this may only be 2-3 ozs. Settle him into his cot for his next sleep and treat it like night-time after that. Feed him in a dimmer room, change him and settle him back to sleep.
By beginning to structure the beginning and end of his day – the 7am start and the 7pm end – you should begin to see a routine emerge. If you can get your son to have a longer sleep in the middle of the day you will be well on the way. It will take a while and you will probably need to follow a routine for a younger baby – perhaps six to eight weeks to begin with – and work your way up to one nearer your son’s age.

Feeding FAQ: 3-4 months – Formula Feeding

At 14 weeks my daughter has begun to need an early morning feed again

My daughter Niamh, who is now 14-weeks-old, was following the routines both with sleeping and feeding until just over 12 weeks. She then began waking again and needing a feed at 3/4am having slept through previously. I fed her for three nights then managed to settle her with water for a few nights but she is demanding a feed again, taking 5ozs which means her daytime routine is now not so good. She seems unwilling to settle for her daytime naps at all, and often wakes again after 20 minutes. She is then too tired to take a full feed, falls asleep, then wakes again because she is still hungry.
At present I breast feed her at 7am and 6.30pm, with bottles at 10.30am:4oz, 12.15pm:2oz, 2.30pm:2oz, 5.00pm:6oz and 10pm:4oz. I find it impossible to keep her awake longer than half an hour at this last feed.
During the day I find it hard to encourage her to take more of a feed when I think she hasn’t taken enough, or to keep her awake when she is tired. Her present weight is 13lbs 6ozs. Until recently she was napping and feeding so well so why has it all gone wrong?

At her present weight, your daughter needs about 33ozs of milk over 24hrs. Even with the two breast feeds you are still giving her, it would seem she is still not taking enough during the day to see her through the night. Taking such a large feed at 3/4am shows this.
Keeping babies awake at 10pm is not always easy, but it is worth the effort as this can affect how well they sleep through the night. Since your husband is often away working, it means you have to do this feed when you are tired as well, which can be difficult. Wake Niamh at 10pm but don’t begin feeding her until nearer 10.30pm. This will ensure she is properly awake and she should take a bigger feed. Another way to cope with this problem, is to wake her nearer 10.30pm and feed her at 10.50pm. Letting her have a kick mid-feed for 20 minutes will also help. Keep the lights on and possibly the TV or radio until the second half of the feed, at which time you lower them so she settles back to sleep easily. Taking nearer 6ozs at this time should help her get through the night without feeding.
By day, keep working towards her settling for a longer lunch time nap. Give her the opportunity to spend plenty of time kicking on her mat after her feed at 10.30am. You could try splitting this feed slightly by giving her a 20min break after 3ozs, with some kicking time, then seeing if she will take another 2-3ozs, which should help her settle for a longer time. Taking her out in her pram at this time may also help her sleep for longer, which means that she might take a slightly bigger feed at 2.30pm.
Some babies of this age do still need an afternoon nap, but it should really be quite short so they will sleep well in the evening and wake up ready for a feed at 10pm.
If Niamh begins to take bigger feeds by day you can begin to cut down on her early morning feed ounce by ounce, so she will wake hungry at 7am.

Feeding FAQ: 3-4 months – Formula Feeding

My 3 month baby is distraught during her bath time. Should I split the 5/6pm feed?

Should I split the 6.15pm feed so my daughter gets a proportion of it at 5.15pm, as she becomes very grumpy at around 5.50pm(bath time) then starts whinging and crying non-stop until she becomes hysterical at 6.10pm! She was born with clubbed feet and wears boots with a bar for 23 out of 24 hours a day. They come off at 5.10pm for an hour (to have a bath and exercise) and I don’t know whether she is getting hysterical prior to them being put back on or whether I’m being ridiculous and she’s too young to know any different, as she’s had them on since she was 6 weeks old. The only thing that calms her is her 6.15pm feed and she takes this so greedily in fact the 220ml bottle is drained within 5 minutes – no exaggeration! If I split the feed will it have a negative impact in other ways? She is taking 180ml of formula at 7.15am, 10.30am, 2.30pm and at 6.15 she takes 220ml followed by 180ml at 10.30pm. She presently weighs 13lbs
Also, our house is being refurbished and we are away for a whole month staying in Surrey for 1 week, Isle of man for 2 weeks and Spain for a further week. I am dreading the effect this will have on the routines as it could be very disruptive with flights etc. Please help!
The routines have been my salvation and my daughter has been a CLB sleeping through until 7am from 10.15pm for 3 weeks.

To help your daughter through this time of day better, by all means split the feed between 5 and 6pm. A lot of babies cannot wait until after their bath, even at this age. Your daughter is probably not that aware of her time without her boots coming to an end but having had a feed at 5pm she will be able to enjoy this time of day better. Taking a slightly bigger feed at this time should not affect the rest of her day adversely. Get her into this new routine now, before you begin to travel.

The time difference to Spain is only one hour, so there should not be too much disruption to her routine. Ask for bulk head seats and most airlines will let you board either first or last, many of them allowing buggy’s to be taken to the door of the plane.

Offer her a bottle of milk or water to suck, on take-off and landing which will help her ears get used to the change in pressure. Once you land in Spain and you are aware how much she may have slept on the flight, you may need to give her a short nap followed by a slightly later bedtime on the first night. The next morning start the day at 7am local time. Giving her feeds at the usual times should help her to stay pretty contented and happy, despite all the moving around you will be doing in the next few weeks. Babies of your daughter’s age are usually pretty adaptable when in different surroundings, providing the same daily routine is kept too as much as possible. Take any familiar toys with you to help her to adjust to sleeping in different rooms. Some mothers like to take bed linen from home which has a familiar smell to put in the cot at night time. Try to keep her nap times in place for most days, as an overtired baby will be harder to settle, especially when away from home.

Feeding FAQ: 3-4 months – Formula Feeding

My 3.5-month-old son is difficult to feed, windy, and is waking in the night again

My son is 16 weeks old. Over the last two weeks has become increasingly difficult to feed, and has started to wake in the night again, although he doesn’t appear to be hungry when he wakes. He dropped the night feed at around 11 weeks old yet, despite not feeding after 10.30pm, he is fairly disinterested in his 7am feed, taking around 100ml. Until recently, though, he has fed well at the other feeds. He has always had a problem with wind and has released a lot from his bottom since he was just a few weeks old. He has also started to regularly wake in the night again, between 3.30 and 5.00am and will chat in his cot for up to half an hour before crying. He does not seem hungry, and will settle when I soothe him, usually with a dummy, and will then sleep until 7am. This week, however, he is taking as little as 60ml at the 7am feed and then cannot go to 11am for the next feed. He then struggles with all the other feeds taking between 60ml and 150ml, depending on how well he fed at the last feed, but he struggles with each one. This week, he has taken as little as 780ml in 24 hours when I believe he should be nearer 1,100ml. He starts the feed well, but then pushes the bottle away and screams as though he is full of wind. I thought as babies got older the wind problem decreased – could it actually be getting worse? I moved him to Avent size 3 teats about 3 weeks ago, but have changed him back to size 2 thinking this might be the problem, however, it doesn’t appear to have solved it. I have used Infacol since he was a week old, and more recently also tried Gripe Water, but I find it very difficult to get him to swallow this. Please help!
At present he sleeps at 9.15-9.55am, 12-2pm and 4-4.20pm.
He takes SMA Gold formula at 7am 90mls, 10.45am 170mls,2.15pm 110mls, 5.00pm 70mls,6.15pm 40mls, 7.10pm 100mls, 10.30pm 140mls.

To get your son more interested in his 7am feed try cutting back on his 10pm. Although he will need a small feed at this time, probably until he is weaned onto solids, try making it 90-120mls and see if he is more interested at 7am. If this helps his overall daily intake then continue to give this small feed until he shows he no longer needs it.

Until he is feeding better at 7am split his 11am feed, giving him about half at 10.15/10.30am and the rest at 11/11.15am. As he appears to be struggling with taking a full feed at most feeds and not being comfortable, consider giving him a 20 minute break mid-feed. This can really help a baby take a better feed, especially if he is troubled by wind. Let him sit in a fairly upright position in his chair to help him begin to digest his milk and also help with any wind that may be trapped.

From your notes it appeared that your son has three feeds between 5pm and 7.30pm. Try to get this down to 2. Feed him 70 ml at 5pm then wait until nearer 6.45pm before offering a larger feed [120-140mls]. Settle him for his sleep by 7pm but notice if he falls straight asleep or takes 15-20 minutes to settle. A baby who goes down exhausted at this time could well wake early in the morning. If he is falling straight to sleep you may have to bring his whole bath and bedtime routine earlier by 15-20 minutes so he drifts off to sleep after a spell of chatting to himself. Make sure he is really awake for at least 45 minutes at 10.30pm, rather than being sleepy, as this can also affect early morning wakings.

Be sure he is not waking through coming untucked from his covers; a baby of this age may still be disturbed by his Moro reflex. If he is in a sleeping bag make sure it is not cold or warmth waking him and check his room is pitch black in the early morning light. All these things can disturb a baby from his light sleep in the early morning.
If he continues to appear very distressed by wind ask your Dr or HV about changing his formula. There is also a product on the market called Colief which helps break down the lactose in milk. Some babies can find this hard to digest. Again ask your Dr or HV about using this in his bottles.

Feeding FAQ: 3-4 months – Formula Feeding

My 13-week-old baby has digestive problems and is taking less and less milk

My daughter is my third baby on the CLB routine because it was such a success with older siblings. I started the routine even in hospital, but she still very quickly developed problems feeding. Initially breast fed, she gulped air as she fed, and as soon as the milk hit her stomach I could hear loud rumbling. She only fed for a bit before screaming, or feeding for a few minutes and refusing any more. Huge burps kept coming – excessive wind I think caused by ingesting so much at a feed. I introduced an expressed bottle in the second week which went fine, but no formula until 6 weeks. As she got older she sometimes fed for longer but would often bring up the feed. Still I would persevere with the routine feed times and sleep times, but often splitting the feeds. I tried all the colic remedies on the market with no success.
At the eight week check, the doctor said she had bit of colic, reflux and an immature digestive system, and that I was to preserve until 12 weeks when it should get better.
In the last 3 weeks I have put her on infant Gaviscon which although seems to be keeping the feeds down, she seems to be taking less and less. She is getting fretful even with the first ounce of milk, taking a few gulps and then not wanting any more. I can’t split the feed when she’s only taken 1oz so I try and wind her, put her down and try again 10mins later in a different position or sitting up in her chair. As you can imagine, she and me start to get distraught, until she falls asleep (at the right time, but only to wake up ½ hour later screaming and even then not wanting to feed at the lunch time nap). I’m keeping a diary and she takes only 20-24 oz in 24 hours.
I now feel like a first time mother who hasn’t a clue. I don’t want to abandon the routine as I know no other way but I need some help as to how to handle the feeding. I have tried different bottles: Dr Browns and Haberman with no success.
The worst time for getting food down her is in the morning. She goes from 11pm until 5ish. She might take 1-2oz between 5 and 7am, but hiccups and screams if I try and feed her at 7/7.30. I give her water if she wakes before 5.
Have you seen this before? How do I handle the nights when I know she’s not taking enough during the day? How can I persuade her to take more in one go?
I have tried the following things:
– Sitting somewhere quite to feed her
– Playing music/TV as background noise to distract her
– Lying her on a bean bag so her back is straight
– Sitting her in her upright chair alternating with a dummy
She weighs 11lbs7ozs and feeds at 5.30am 1-2ozs, 7.30am 3ozs, 10.30am 2ozs, 11.30am 2ozs, 1pm 1oz, 2.30pm 3ozs, 5.55pm 3ozs, 6.30pm 3ozs, 10.30pm 3ozs.
She naps at 9-9.40am, 12-12.50pm,1.30-2pm, 4-4.30pm and settles at 7pm.

As your daughter’s feeding is not improving at all return to your doctor and insist on a referral to a gastric specialist. At her weight she needs more in the region of 28 ozs a day . Although the Gaviscon has stopped the vomiting the way she feeds taking in so little before becoming distressed needs investigating.
There are a couple of practical things you could do straight away. On your notes you are feeding her with a no3 teat and Avent bottle. You could try a smaller teat size as this one will be quite fast . This may be causing her to gulp at the milk and swallow excessive air whilst doing so. You could also try a variflo teat which means you can regulate the flow from slow to fast. Avent make their own but Tommee Tippee also make a Variflo teat which will fit Avent bottles too. This has a x cut in the top instead of holes and works with different speeds according to the rate and strength of the babies suck. This can help a baby who becomes overwhelmed with milk flowing too fast.
Sometimes babies who are difficult to feed can do better if you hold them in an upright position and move around the room at the same time. Walking seems to calm them enough to take in the milk steadily, rather than gulping at it.
At night time and during naps let your daughter sleep on a raised mattress. Do this by placing telephone directories or large books under the legs of the top end her cot or used rolled towels under the mattress so she is sleeping on a sloped rather than flat surface. You van buy special wedge shaped pillows from some nursery outlets which will also slope the mattress.

Feeding FAQ: 3-4 months – Formula Feeding

How do I have a feeding routine with my 3.5 month old who suffers from reflux?

I have always tried to follow the schedules, but firstly I could not properly breast feed, then my son suffered horribly from acid reflux in his first 2 months. After his first week of treatment with Zantac, he was angelic. His schedule just fell into place. Then things went very wrong and he continues to buck and thrash when I try to initially give him his bottle. He will settle after a few minutes, but then he has exhausted himself so, that he can barely take 4oz at a time. The only time of day that is predictable is from 5 pm until about 4-5am. He can manage the schedule and with a split feed, can take 6-7 oz at dinner. I have been back to work for a week now and the nanny confirms the same. He struggles to eat and it is affecting his sleep. Naps are not much longer than 45mins. This bucking and wriggling also shows up when he is tired. When he has had enough and is tired, he will cry/scream. Walking and jostling will settle him only briefly. If I were to try to lay him in his crib at this point it would be an all-out fit. Some days he sleeps 3-4 hours, some days only 2-3 hours. He has been chewing his hands since he was 8 weeks and it is getting worse, but no teeth are breaking in.

My son is a lovely baby, giggling, generally happy and easy going, but we struggle to get him to feed and sleep on any schedule. His early months I tried to accomplish errands when he was wake and he sometimes spent short spurts with the nanny. Currently I drop him off to the nanny at 8am and collect him by 5.30pm. The nanny has to drop of my niece and nephew to school between 8.15-9 and pick them up from 2.30-3pm. So my son’s only “quiet time”, alone with the nanny is from 9am-2pm and I have my doubts that she tries to follow the schedule as strictly as I do. I also know that my niece and nephew scream down the house playing in the afternoon, so it is quite hectic.

He feeds at 4-6am: 2-4ozs, 7-8am: 2+ozs, 10.30am: 4-6ozs, 1pm: 2-4ozs, 2pm: 4ozs, 5pm: 2ozs, 6.15pm: 4ozs, 10.30pm: 4ozs. Water is given throughout the day when necessary, he takes around 4-6ozs daily. He weighs 12+lbs.
He naps at 9.45-10.45am, 12-1pm, 2-3pm. He is settled at 7pm.

Babies who have problems with reflux do better with smaller and more frequent feeds. They are also easier to feed when they are relaxed which is probably why your son feeds better later in the day and at night.
If your son has not had a check up recently, get one booked in straight away as his medication may need altering to help him not to be in such discomfort when feeding.
To help his intake, try feeding him 3ozs at a feed and then let him have a 15-20 min break whilst sitting in a fairly upright position in his chair. He needs to be at an angle but not in a “v” shape as this will cause his stomach to be constricted and cause him further discomfort. Offer him another 2-3ozs after this break and see if you can get his daily intake up to nearer 30ozs which is the average for his weight.
Watch how much water you do give him because if you give him too much at the wrong time of day could take the edge of his appetite and so he will only want a small feed when it is next due.
To help him settle better at lunchtime offer him a top up before going down so he is not likely to wake at 1pm through hunger. Even an extra 1oz given at this time could help him have a better lunchtime nap.
Babies with reflux can be calmed by using a dummy to suck on. This could be used either in his break or after a feed if he is showing signs of distress. Sucking on a dummy can help saliva production. As this is alkaline it has a neutralizing effect on some of the stomach acid as it comes up. You could possibly replace some of the water given to him throughout the day with a short time sucking on a dummy, especially if a feed is due within an hour.
When winding him rub, rather than pat, on the left side of his back. Rub gently in circles and then upwards as you hold him upright on your shoulder. This will help to keep the oesophagus as straight as possible to help him wind without too much added discomfort.
You may find it also useful to use a dummy to help calm him ready for his naps so he is not going down over tired and upset. At least 15-20mins before his nap is due he needs to be taken to where he will sleep and the same calming routine set in place. This could involve a change, some quiet holding in an upright position and offered a dummy. Looking out of the window and talking quietly about what you see will help him relax. Pull the blinds and curtains and settle him in his cot before he is too tired and begins to fight sleep. Getting him into his cot before he becomes too tired should help him to settle better and hopefully sleep for longer. With other children around it is not always easy to notice that a baby is showing signs of tiredness but as your nanny is alone with your son at the times of his morning and lunchtime nap this should not be too difficult to put a calming wind down time into place.
Make sure that he sleeps on an angled mattress. This can be done by raising the feet at the cot end using thick books or telephone directories or rolled towels under his mattress so his head is higher than his body. You can buy special wedges to fit under a cot mattress which do the same thing.
Dealing with reflux and the problems it brings is difficult. Keep working on improving the feeds which in turn may help the sleep improve and as the months pass your son should begin to grow out of this distressing condition.